ADULT ONSET NOCTURNAL ENURESIS

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2001ADULT ONSET NOCTURNAL ENURESIS KYOKO SAKAMOTO, and JERRY G. BLAIVAS KYOKO SAKAMOTOKYOKO SAKAMOTO More articles by this author , and JERRY G. BLAIVASJERRY G. BLAIVAS More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66241-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the etiology and prognostic significance of adult onset enuresis with absent daytime incontinence. Adult onset nocturnal enuresis unassociated with daytime incontinence is uncommon and there is a paucity of information about its incidence, significance, evaluation and treatment. We present a retrospective evaluation of this condition based on a database review of more than 3,000 consecutive patients referred for the evaluation of lower urinary tract symptoms. Materials and Methods: A database of 3,277 consecutive patients was searched for adult onset nocturnal enuresis. Patients with daytime incontinence were excluded from study. Evaluation consisted of history, physical examination, American Urological Association symptom score, voiding diary, uroflowmetry, estimation of post-void residual urine, video urodynamics, cystoscopy and radiographic evaluation of the upper tract. Results: Of 3,277 patients 8 (0.02%) had adult onset nocturnal enuresis without daytime incontinence as a primary complaint. Average American Urological Association symptom score was 12.6 (range 3 to 25), average maximum urine flow was 8.5 ml. per second (range 5 to 15) and average post-void residual urine volume was 350 ml. (range 50 to 489). All patients were men with severe prostatic or vesical neck obstruction as well as bilateral or unilateral hydronephrosis in 63%, a bladder diverticulum in 38%, vesicoureteral reflux in 50% and low bladder compliance in 50%. Transurethral prostatic resection was recommended to all patients but only 5 agreed. The other 3 cases were managed by α-adrenergic antagonists, including 2 by adjunctive clean intermittent self-catheterization. In all patients who underwent transurethral prostatic resection symptoms resolved, as did hydronephrosis when present. Conclusions: Adult onset nocturnal enuresis with absent daytime incontinence is a serious symptom that usually heralds significant urethral obstruction, and a high incidence of bladder diverticulum, hydronephrosis and vesicoureteral reflux. It demands urological investigation and aggressive therapy. References 1 : Enuresis. In: Campbell’s Urology. Edited by . Philadelphia: W. B. Saunders1998: 2065. chapt. 66. Google Scholar 2 : Nocturnal enuresis. A new strategy for treatment against a physiological background. Scand J Urol Nephrol1992; 143: 1. Google Scholar 3 : The urodynamic assessment of adult enuresis. Br J Urol1975; 47: 433. Google Scholar 4 : Rationale of urodynamic assessment in adult enuresis. Eur Urol1992; 21: 138. Google Scholar 5 : Adult enuresis-a symptomatic and urodynamic assessment. Br J Urol1980; 52: 88. Google Scholar 6 : Nocturia. J Urol2000; 163: 5. Link, Google Scholar 7 : Standardisation of terminology of lower urinary tract function. Neurourol Urodyn1988; 7: 403. Google Scholar 8 : Principles and clinical application of advanced urodynamic analysis of voiding function. Urol Clin North Am1990; 17: 553. Google Scholar 9 : Bladder outlet obstruction versus impaired detrusor contractility: the role of uroflow. J Urol1991; 145: 810. Link, Google Scholar 10 : Bladder function in healthy elderly males. Scand J Urol Nephrol1978; 12: 123. Google Scholar 11 : Defining bladder outlet obstruction in benign prostatic hyperplasia. AUA Update Series1996; vol. 15. lesson 2. Google Scholar 12 : Enuresis in an adult female with obstructive sleep apnea. Urology1995; 45: 150. Google Scholar From the Department of Urology, Weil Medical College, Cornell University, Ithaca and Urocenter of New York, New York, New York, and Loyola University Medical Center, Maywood, Illinois© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByHJALMAS K, ARNOLD T, BOWER W, CAIONE P, CHIOZZA L, von GONTARD A, HAN S, HUSMAN D, KAWAUCHI A, LÄCKGREN G, LOTTMANN H, MARK S, RITTIG S, ROBSON L, WALLE J and YEUNG C (2018) NOCTURNAL ENURESIS: AN INTERNATIONAL EVIDENCE BASED MANAGEMENT STRATEGYJournal of Urology, VOL. 171, NO. 6 Part 2, (2545-2561), Online publication date: 1-Jun-2004. Volume 165Issue 6 Part 1June 2001Page: 1914-1917 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsbladder neck obstructionurethral obstructionenuresisbladderMetricsAuthor Information KYOKO SAKAMOTO More articles by this author JERRY G. BLAIVAS More articles by this author Expand All Advertisement PDF DownloadLoading ...